2058
THE NEW ZEALAND GAZETTE.
[No. 86

DEDUCTIONS.
Rent payable for farm to [Give name and address
of person to whom rent paid]
Rates .. .. .. .. ..
Insurance .. .. .. ..
Mortgage interest payable to [Give names and
addresses of persons to whom interest paid]
Other interest payable to [Give names and ad-
dresses of persons to whom interest paid]
Seed bought (includes only for annual crops
and renewals of pasture)
Feeding-stuff bought for stock (not to include
feeding-stuff grown on farm or any produce
received in exchange for live-stock, &c.)
Wages paid for labour, &c., on farm (not to
include labour on improvements or any
allowance for taxpayer’s own services)
Rations bought for employees whose labour is
included in foregoing item (not to include
produce of farm used for feeding employees)
Repairs and maintenance (not to include ad-
ditions or improvements to property or plant)
Freight and cartage .. .. ..
Manure, sacks, twine, cases, woolpacks ..
Threshing (not to include any item included
above in wages)
Petty expenses .. .. .. ..
Other expenses (to be specified) :
[Continue on a separate sheet, if necessary]

Net income .. .. .. £

A copy of the taxpayer’s balance-sheet and profit and loss account
or statement of assets and liabilities at the beginning and end of the
year, accompanied by a statement of drawings, will be accepted in lieu
of the above statement.

PART E.
INCOME FROM SALES OF LAND DURING THE YEAR ENDED
, 19 .
£ £
Sales of land during the year : [Area], sold for
Land unsold at end of year at cost price, plus
improvements : [Area], valued at

Less land held at beginning of year at cost
price, plus improvements : [Area], valued at
Purchases of land during the year : [Area],
bought for
Expenditure during the year on im-
provements : [Specify nature of im-
provements]

Gross income .. ..
Less other expenses incurred during the year,
namely :—

Net income .. £

STATEMENT NO. 1.—NAMES, ADDRESSES, AND SHARES OF
PARTNERS.
(To be filled up in the case of returns made by or on account
of a firm or partnership.)

This total should agree with “Total assessable income”
on Summary .. .. .. .. .. £

STATEMENT NO. 2.—TRUSTEES’ STATEMENT.
(To be filled up in the case of a deceased person’s estate or other
trust.)

This total should agree with “Total assessable income”
on Summary .. .. .. .. .. £

REFERENCE TO INCOME SHOWN
IN OTHER RETURNS.
In addition to the income
included in this return, I am
beneficially interested in the
following partnerships, syndi-
cates, businesses, or under-
takings :—

SUMMARY.
£ s. d.
Net income shown in
Part B
Net income shown in
Part C
Net income shown in
Part D
Net income shown in
Part E

Total assessable
income £

PART H.
RETURN OF DIRECTORS, AUDITORS, AND OTHERS.
(This Part applies to registered companies only.)
(All amounts should be included in this list.)

• The figures in these columns should represent the actual salary or
  emolument for the year ended 31st March, 19 , and not for the period
  covered by the taxpayer’s balance-sheet if made up to another date.

Schedules to Form No. 3.
SCHEDULE A.—RETURN TO BE SUPPLIED BY BANKING
COMPANIES.
(a) Total assets and liabilities of the banking com-
pany for the four quarters ending respectively
on—
30th June, 19 .. .. .. £
30th September, 19 .. .. ..
31st December, 19 .. .. ..
31st March, 19 .. .. ..
(b.) Average of total assets and liabilities for the
four quarters .. .. .. ..
(c.) Income derived by banking company during
income-year as interest on debentures issued
under the New Zealand Loans Amendment
Act, 1915 .. .. .. ..

SCHEDULE B.—RETURN TO BE SUPPLIED BY INSURANCE
COMPANIES (OTHER THAN LIFE-INSURANCE COMPANIES).
Statement of Gross Income from Business and Deductions
therefrom.
NOTE.—This may be taken for TWELVE MONTHS ending at date of
stocktaking or annual balance nearest to 31st March.
For the Year ending , 19 .

Gross premiums received .. .. ..
Less : Returns .. .. ..
Reinsurances (with companies re-
presented in New Zealand only) | | |
Deduct losses on risks undertaken in New
Zealand, less recoveries | | |
Income from investments .. ..
Other income in New Zealand .. .. | | |
Gross income in or from New Zealand .. £ | | |